Cerebellar mutism after removal of a vermian medulloblastoma in an adult

Cerebellar mutism is a rare postoperative phenomenon that generally occurs in children after resection of a cerebellar mass lesion. A 22-year-old man developed cerebellar mutism after posterior fossa surgery for a mass lesion in the vermis. Histological examination showed a medulloblastoma. The tumor was totally removed via a suboccipital approach. The patient developed mutism on the first postoperative day, which persisted for two weeks. Thereafter, this condition gradually improved. Although pathophysiology and the anatomical substrate of cerebellar mutism still remain unclear, it is important that neurosurgeons be aware of this syndrome after posterior fossa surgery in adults. This phenomenon usually has a self-limiting course and a favorable prognosis for resolution within the first three months. (C) 2008 Elsevier Masson SAS. Tons droits reserves.